Faculty Bibliography

INTRODUCTION/BACKGROUND:There is a lack of epidemiology studies on cemental tears. This study aimed to (i) investigate the prevalence of cemental tears among the patients referred to a Postgraduate Endodontic Clinic, (ii) classify the cases diagnosed with cemental tears, and (iii) assess factors associated with cemental tears. MATERIALS AND METHODS/METHODS:This retrospective, cross-sectional study included 445 cases/teeth recruited between 1 September 2019 and 31 March 2024 at a University Postgraduate Endodontic Clinic. Information was collated from the clinical records of case history, clinical findings and radiographic interpretations from periapical radiograph (PR) and cone beam computed tomography (CBCT) images. For each case/tooth, cemental tear/s were categorised as either absent or present, and those with cemental tear/s were further classified. Thirty potential factors were studied, including patient-, jaw-, tooth-, previous endodontic treatment and periodontal-related factors. Factors were individually tested using univariate analysis with Pearson chi-squared (exact) tests. Any significant factors identified were further subjected to multiple logistic regression analyses based on a forward stepwise regression model (p < 0.05). RESULTS:Cemental tear/s were found in 25 out of 445 cases/teeth, with a prevalence of 5.6%. Sensitivity and specificity of PR in detecting cemental tears were 0.6 and 1.0, respectively. Most cases/teeth detected were classified as Class 2 and 4 (n = 19, 76%) or Stage C and D (n = 19, 76%). Mean age of the subjects with cemental tears was 58.7 years, with comparable prevalence between males and females. Most cases (72%) with cemental tear/s had root canal treatment initiated or completed. Incisors, increased tooth mobility, severe crestal bone loss and adequate root filling quality were significantly associated with the higher prevalence of cemental tears (p < 0.05). CONCLUSION/CONCLUSIONS:Cemental tears should always be considered as a differential diagnosis in endodontic practice. Clinicians should be particularly vigilant for increased risks of cemental tears in incisors, mobile teeth, teeth exhibiting increased crestal bone loss and those with adequately filled root canals, as they may be misdiagnosed as periodontal-endodontic lesions. The use of CBCT is crucial for accurate diagnosis, guiding effective treatment planning and improving clinical outcomes in endodontic management.

Although platelets play a critical pathogenic role in myocardial infarction (MI), few studies have characterized the MI platelet transcriptome in the acute or chronic setting in women. We report that transcripts associated with the actin cytoskeleton, Rho family GTPases, mitochondrial dysfunction, and inflammatory signaling are enriched in platelets from MI patients in the acute setting (n = 40, MI; n = 38, control) and do not significantly change over time. Furthermore, 79 platelet genes chronically elevated or suppressed after MI are associated with future cardiovascular events in an independent high-risk cohort (n = 135). Compared with women with MI with nonobstructive coronary arteries, platelets from women with MI and obstructive coronary artery disease were enriched in neutrophil activation and proinflammatory signaling pathways driven by increased tumor necrosis factor (TNF)-α signaling. Hierarchic clustering of the MI transcriptomic profile identified 3 subgroups with distinctive biological pathways and MI correlates. Our data demonstrate that platelets from MI patients are phenotypically different from MI-naïve patients in the acute and chronic settings and reveal a platelet transcriptomic signature with distinct clinical features.

AIM/OBJECTIVE:To investigate how psychosocial stress contributes to accelerated thrombosis, focusing on platelet activation and hyperreactivity. The specific objective was to identify novel platelet regulators involved in stress-mediated thrombosis, with a particular emphasis on the tetraspanin CD37. METHODS AND RESULTS/RESULTS:To explore how stress contributes to platelet hyperreactivity, platelets were isolated from (1) mice that experienced chronic variable stress and stress-free controls (n=8/group) and (2) human subjects with self-reported high and no stress levels (n=18/group), followed by RNA-sequencing. By comparing mutually expressed transcripts, a subset of genes differentially expressed following psychosocial stress was identified in both human and mouse platelets. In both mice and humans, platelet CD37 positively associates with platelet aggregation responses that underlie thrombosis, with Cd37-/- platelets exhibiting impaired integrin αIIbβ3 signaling, characterized by reduced platelet fibrinogen spreading and decreased agonist-induced αIIbβ3 activation. Consistent with a role for CD37 in regulating platelet activation responses, chimeric mice that received Cd37-/- bone marrow experienced a significantly increased time to vessel occlusion in the carotid artery FeCl3 model compared to mice reconstituted with wild-type bone marrow. CD37 deficiency did not alter hemostasis, as platelet count, coagulation metrics, prothrombin time, and partial thromboplastin time did not differ in Cd37-/- mice relative to wild-type mice. Consistent with this, bleeding time did not differ between wild-type and Cd37-/- mice following tail tip transection. CONCLUSIONS:This study provides new insights into the platelet-associated mechanisms underlying stress-mediated thrombosis. Identifying CD37 as a novel regulator of platelet activation responses offers potential therapeutic targets for reducing the thrombotic risk associated with psychosocial stress. The findings also contribute to understanding how psychosocial stress accelerates thrombotic events and underscore the importance of platelet activation in this process.

Psychosis in Parkinson's disease (PD) is common and associated with a range of negative outcomes. Dementia and psychosis are highly correlated in PD, but the frequency and correlates of psychosis in patients without cognitive impairment are not well understood. One hundred and ninety-one non-demented PD patients at two movement disorders centers participated in a study of neuropsychiatric complications in PD and completed a detailed neurological and neuropsychiatric assessment, including the rater-administered Parkinson Psychosis Rating Scale for hallucinations, delusions, and minor symptoms of psychosis (illusions and misidentification of persons). Psychotic symptoms were present in 21.5% of the sample. Visual hallucinations were most common (13.6%), followed by auditory hallucinations (6.8%), illusions or misidentification of people (7.3%), and paranoid ideation (4.7%). Visual hallucinations and illusions or misidentification of people were the most common comorbid symptoms (3.1%). Depression (P = 0.01) and rapid eye movement behavior disorder symptoms (P = 0.03) were associated with psychosis in a multivariable model. The odds of experiencing psychotic symptoms were approximately five times higher in patients with comorbid disorders of depression and sleep-wakefulness. Even in patients without global cognitive impairment, psychosis in PD is common and most highly correlated with other non-motor symptoms. Screening for psychosis should occur at all stages of PD as part of a broad non-motor assessment. In addition, these findings suggest a common neural substrate for disturbances of perception, mood, sleep-wakefulness, and incipient cognitive decline in PD.